Extra-orally Cemented Maxillary First Bicuspid

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1.

Pre-operative radiograph.

2.

Pilot drill initiating osteotomy immediately after the extraction of first bicuspid.

3.

5.0mm x 8.0mm HA coated implant on an implant inserter / retriever instrument.

4.

Implant being inserted into osteotomy.

5.

Implant is being displaced from implant inserter / retriever instrument by holding one treaded knob and turning the other threaded knob.

6.

Implant in osteotomy prior to its being finally seated.

7.

Seated implant in osteotomy.

8.

Shoulder depth gauge seated in implant well facilitating the selection of abutment with an appropriate shoulder height relative to the crest of the soft tissue.

9.

Acid etching of enamel for the cement bonding of stabilization prosthesis.

10.

Vacuum formed template adaptation being confirmed prior to the fabrication of the transitional stabilization prosthesis.

11.

Transitional composite material being injected around one piece acrylic sleeve.

12.

Stabilization prosthesis being fabricated with a vacuum formed template.

13.

Radiograph of 4.0mm x 1.5mm shouldered abutment seated with only finger pressure in the implant well supporting the bonded stabilization prosthesis.

14.

Bonded stabilization prosthesis prior to its removal for the insertion of a white impression transfer post.

15.

Impression material being injected around white impression post for the making of an implant level transfer impression.

16.

Aluminum oxide sleeve on soft tissue model.

17.

All-ceramic crown on soft tissue model.

18.

Mirror view of all-ceramic crown revealing aluminum oxide core.

19.

After intra-oral confirmation of color and morphology of the all-ceramic crown, metallic bonding agent is being applied to shoulder abutment.

20.

Ceramo-coupler is being applied to aluminum oxide core.

21.

Bonding agent is being applied to both the post and aluminum oxide core.

22.

Light curing of bonding agent.

23.

Bonding cement being applied to aluminum oxide core.

24.

All-ceramic crown being extra-orally cemented onto shouldered abutment.

25.

Extraneous cement being removed with a cotton applicator.

26.

Extra-orally cemented crown being inserted into well of implant.

27.

Initially seated all-ceramic crown.

28.

All-ceramic crown being tapped into implant well.

29.

Radiograph of seated all-ceramic crown.

30.

Three month post insertion view of first bicuspid all-ceramic crown. Note change in inter-dental papillae.

31.

Six month post insertion view of all-ceramic crown and inter-dental papillae.